Hepatic Elimination of Indocyanine Green with Special Reference to Distribution Kinetics and the Influence of Plasma Protein Binding

Ott, Peter

doi:10.1111/j.1600-0773.1998.tb01945.x

Cited by 93 publications

(71 citation statements)

References 191 publications

(337 reference statements)

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“…10,11 Adverse reactions related to its clinical use are rare, and side effects other than iodine allergy have not been reported. 10,12,13 In plasma, it displays an absorption maximum at 805 nm and an emission maximum at 830 nm. 10 The ICG fluorescent dye was administered intravenously through a central venous line to ensure adequate mixing of the ICG.…”

Section: Myocardial Perfusion Measurement With Fcimentioning

confidence: 99%

Fluorescent Cardiac Imaging

et al. 2007

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Background-The purpose of the present study was to examine whether the effect of coronary stenoses of variable severity on myocardial perfusion can be quantitatively assessed in vivo by analysis of fluorescent cardiac imaging (FCI) compared with the gold standard, the fluorescent microsphere method. FCI is a novel technology to visualize coronary vessels and myocardial perfusion intraoperatively using the indocyanine green dye with an infrared-sensitive imaging device. Methods and Results-Graded stenoses and total vessel occlusion of the left anterior descending coronary artery were created in 11 open-chest pigs. Stenoses were graded to reduce resting left anterior descending coronary artery flow by 25%, 50%, 75%, and 100% of baseline flow measured by transit-time flowmeter. FCI images were analyzed with a digital image processing system. The impairment of myocardial perfusion was quantified by background-subtracted peak fluorescence intensity and slope of fluorescence intensity obtained with FCI and compared with myocardial blood flow assessed by fluorescent microsphere. All stenoses resulted in an impairment of myocardial perfusion visualized by FCI. Occlusion of the left anterior descending coronary artery resulted in a total perfusion defect (no fluorescence intensity) of the corresponding anterior myocardial wall. During graded stenosis and total vessel occlusion, normalized background-subtracted peak fluorescence intensity and slope of fluorescence intensity decreased significantly (PϽ0.0001). Both background-subtracted peak fluorescence intensity (rϭ0. Clinical Perspective p 1014At present, there are several technologies to assess intraoperative bypass function, including intraoperative coronary angiography, thermal coronary angiography, ultrasound transit-time flow measurement (TTFM), and high-frequency epicardial echocardiography. However, all these techniques have limitations such as invasivity, misinterpretation, or poor resolution, and the clinical impact of most of these methods remains an unsolved issue. 2,3 Recently, we described the value of a novel, indocyanine green (ICG) -based imaging system (LLS GmbH, Ulm, Germany) for intraoperative visualization of blood flow in 4 -6 Thus, indirect parameters to detect anastomotic stenoses were evaluated in the present study. Our group has previously shown that this technique also allows the visualization of myocardial perfusion, providing further information with respect to the blood supply to the corresponding myocardium. 8 Visualized by fluorescent cardiac imaging (FCI), coronary stenoses resulted in an impairment of myocardial perfusion, and vessel occlusion resulted in a total perfusion defect of the corresponding myocardial region. 4 Although high-quality images of myocardial perfusion were obtained by FCI, quantitative assessment of myocardial perfusion deficits was not yet possible. 4 The aims of the present study were to quantitatively assess the effect of different coronary stenoses on myocardial perfusion by analysis of FCI and to compare the...

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Section: Myocardial Perfusion Measurement With Fcimentioning

confidence: 99%

Fluorescent Cardiac Imaging

et al. 2007

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“…where IR is the infusion rate of ICG; Ca and Cv are the concentrations of ICG in the brachial artery and in the hepatic vein, respectively; dC a/dt is the Ca accumulation rate; VdICG is the volume of distribution of ICG (plasma volume); dCa/dt ϫ VdICG represents a correction for minor deviations from steady-state conditions (25). VdICG was estimated as 0.05 ϫ body weight (kg), and dCa/dt was expressed as the linear regression for the five samples (25,26).…”

Section: Subjectsmentioning

confidence: 99%

“…The ICG dye concentration was determined by high-performance liquid chromatography with a detection limit of 0.01 mol/l (25). Paired samples of arterial and hepatosplanchnic venous blood were collected in heparinized syringes (QS50; Radiometer, Copenhagen, Denmark).…”

Section: Subjectsmentioning

confidence: 99%

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Hepatosplanchnic clearance of interleukin-6 in humans during exercise

Febbraio

Ott

Nielsen

et al. 2003

American Journal of Physiology-Endocrinology and Metabolism

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The cytokine interleukin (IL)-6 can increase markedly in the circulation during exercise, but whether the liver is a source of this increase is unknown. The aim of this study was to measure IL-6 flux across the hepatosplanchnic tissues in humans. To elevate systemic concentrations of IL-6, six healthy male subjects performed 120 min of semirecumbent cycling, and blood samples were simultaneously obtained from a brachial artery and the hepatic vein before and during exercise for the analysis of IL-6. Hepatosplanchnic blood flow (HBF) was measured using the indocyanine green infusion technique. Net hepatosplanchnic IL-6 balance was calculated from these measures. HBF was 1.3 ± 0.1 l/min at rest and was not reduced throughout exercise, averaging 1.1 ± 0.2 l/min. Arterial plasma IL-6 markedly increased ( P < 0.05) from 1.8 ± 0.6 ng/l at rest to 14.3 ± 3.2 ng/l after 120 min of exercise. The hepatosplanchnic viscera did not contribute to this increase, since there was a net hepatosplanchnic IL-6 uptake (0.8 ± 0.3 vs. 5.5 ± 1.9 ng/min, rest vs. 120 min; P < 0.05). These data demonstrate that the hepatosplanchnic viscera remove IL-6 from the circulation in humans. This removal may constitute a mechanism limiting the negative chronic metabolic action of chronically elevated circulating IL-6.

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“…The ICG is detectable in the bile 15 min after injection, with a maximum concentration between 30 min and 2 h after injection, depending on the amount injected. The kinetics of ICG plasma disappearance has been described in previous articles [20,21]. Because of the ICG metabolism, a dynamic test has been used largely to assess hepatic function as well as portal and hepatosplanchnic blood flow [10,22,23].…”

Section: Discussionmentioning

confidence: 99%

Intermittent Pringle Maneuver and Hepatic Function: Perioperative Monitoring by Noninvasive ICG‐Clearance

Tralhão

Hoti

Oliveiros³

et al. 2009

World j. surg.

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Background Intermittent Pringle maneuver or selective portal clamping often are used to control inflow during parenchymal liver transection. This study was designed to determinate whether these maneuvers are associated with adverse hepatic function. Methods Resection was performed without portal clamping in 17 patients (group 1). Selective continuous portal clamping was performed in 11 patients (group 2) and the remaining 33 patients (group 3) had intermittent nonselective portal clamping (occlusion of the main portal trunk). The centers' protocol for total portal occlusion is 15-min occlusion alternated with 5-min reperfusion in patients with normal liver parenchyma or 10 min alternated with 5 min in patients with abnormal parenchyma. ICG elimination tests were conducted concurrently using a noninvasive monitor that tracks the plasma disappearance rate (PDR-ICG-%/min) and 15-min retention rate after administration (ICG-R15-%). Results There was no statistically difference between the three studied groups in terms of sequential changes of ICG-PDR (p \ 0.625) or ICG-R15 (p \ 0.398).Conclusions Our study indicates that 15 min of intermittent Pringle maneuver or selective hemihepatic continuous portal clamping are safe methods of vascular control during liver resection, with no adverse effects on hepatocellular function.

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Hepatic Elimination of Indocyanine Green with Special Reference to Distribution Kinetics and the Influence of Plasma Protein Binding

Cited by 93 publications

References 191 publications

Fluorescent Cardiac Imaging

Fluorescent Cardiac Imaging

Hepatosplanchnic clearance of interleukin-6 in humans during exercise

Intermittent Pringle Maneuver and Hepatic Function: Perioperative Monitoring by Noninvasive ICG‐Clearance

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